MDMA-assisted psychotherapy

[1][2][3] In 2017, a Phase II clinical trial led to a breakthrough therapy designation by the U.S. Food and Drug Administration (FDA) for potential use as a treatment for PTSD.

MDMA makes it easier for a patient to stay in the optimal arousal zone by decreasing feelings of anxiety and defensiveness when revisiting traumatic memories.

[10] By increasing feelings of closeness and empathy, it can improve the patient's trust in the therapist and encourage introspective thought to reassess memories and actions.

Adverse effects, which can last from a few hours to several days, include diminished appetite, anxiety, headache, jaw tightness, tinnitus, nausea, asthenia (weakness), fatigue, sinusitis, nasopharyngitis, upper respiratory tract infection, disturbance in attention, tremor, tics, dysuria, erythema, and depression.

A phase III study indicated that MDMA-assisted therapy represents a potential breakthrough treatment for severe PTSD that merits expedited clinical evaluation.

Given that unprocessed trauma is considered a causative factor in some individuals with depression, it has been proposed that the benefit observed in PTSD trials might be applicable to MDD as well.

[26] Psychotherapists using MDMA for therapeutic purposes initially desired to keep its use within the clinical research community; however, the medication gained popularity in the club scene in the early 1980s.

The scheduling of MDMA made it illegal to manufacture, possess, or distribute, essentially ending the practice of MDMA-assisted psychotherapy in the United States.

[26] Switzerland continued to study the drug for use in individual, couple, and group therapies until 1993, when the Swiss Ministry of Health withdrew permission to use MDMA and LSD by psychiatrists due to concerns about a lack of research methodology.

[26] In 1986, MDMA was classed as a Schedule I drug by the United Nations according to its Convention on Psychotropic Substances of 1971 due to increasing rates of non-clinical use and police seizures, along with its high potential for abuse.

[9][12] The drug causes neurotransmitter activation across the main neural pathways (e.g., serotonin, dopamine, noradrenaline) that can result in large mood swings.

[9] Once the effects of MDMA wear off, there is a "period of neurochemical depletion" that invokes anhedonia, lethargy, anger, depression, irritability, brooding, greater everyday stress, altered pain thresholds, changes in sleep, and bad dreams, especially in female participants.